Side effects from Lactulose...Need advice ASAP!

[mosimom]

I've read of many mega colon cats doing great with miralax as the treatment.
There is a mega colon yahoo group here:
https://groups.yahoo.com/neo/groups/Feline_Megacolon/info

 

[cocheezie]

A number of cats do not respond to lactulose, but do respond to miralax. My severely constipated cat is one of them. Lactulose did nothing. Good luck with your little one.

 

[peaches08]

There's been a number of members who have been able to help their kitties with cisapride, one of them is @AbbyNTim.  Put "cisapride" in the search bar above on this website and you'll see quite a few threads come up about it.

 

[lvnoah]

 
Update: I took Lily into the vet this morning as soon as they opened & they did another xray and he's just as constipated as he was 10 days ago. However, they said the stool is soft which means he has megacolon because he doesnt have the muscle tone to pass it. That's really sad news for me because unfortunately it means that this is something we would have to deal with forever and run the risk of Lily being in pain whenever he gets constipated again, which is inevitable. We're trying one last thing, which is another enema while he's awake and injecting him with Cispride to help him pass it. If he can't pass it on his own with the help of that, we're going to have to make a tough decision because it means that the Cisapride isn't helping him and he just cant go on his own. If it does help him, he will be on the Cisapride and a low dose of lactulose for the rest of his life but the vet said there's no guarantee that wont be back in a week for the same issue.

Tough decisions having to be made today

I'm sorry you got some tough news from the vet.  I'm surprised he's constipated again.  Makes me wonder if they even did a proper clean out the first time.  Did they tell you what he had done? Did they show you his actual x-rays from both times he had this done? 

If you can afford it, I would find another vet (one who treats this frequently) and get a second opinion.  There are still many things that you can try to help manage his mega colon (diet, meds, surgery, etc.). I'm working with my own kitty on this.  I certainly make mistakes and learn things along the way but he is still here and happy as ever. 

Also, please post on the Yahoo Group that is specifically for cats with mega colon.  Someone posted the link in another post.  Just a warning though, sometimes it takes a while for posts to show up, but they always eventually do.  The people there are very supportive and knowledgeable on this issue. 

Try to hang in there.  Sending you good thoughts.

 

[abbyntim]

I am sorry you are dealing with this. I agree about a second opinion because there are other things to consider and some "lifestyle changes" that can really help.

Our cat Tim had two episodes similar to Lily's, two years apart. After the second one, the vet put him on cisapride and warned us Tim was a tiny step away from megacolon. I recently weaned Tim off cisapride after he was on it for just about a year. His last dose was June 26, 2014, and he has been pooping perfectly ever since then. We did all sorts of things, but I think the key to Tim's issues are:

• Improving digestion by adding a daily probiotic.
• Increasing hydration by transitioning from mostly dry food to almost all wet food.
• Reducing stool size by feeding a low carb and low residue diet.
• Helping intestinal bacteria do their job by providing small amounts (1/32 tsp) of the right kind of fiber - usually one or a blend of slippery elm bark and psyllium.
• A tiny amount of Miralax (1/16-1/8 tsp) on an as-needed basis to soften hard stool. We have used this only once so far, and that was when we first transitioned Tim to mostly raw food; now that he's adapted to raw, everything looks good.
• Slightly larger doses of psyllium (1/16-1/8 tsp) on an as-needed basis to stimulate the urge to poop. We've used this a couple of times and mostly following the initial transition to raw. (And looking back, I don't think he needed it; I think I needed to become comfortable with the fact that he poops less on raw).

Cisapride, as you know, increases motility. Lily may or may not need it long term, but it might be useful to "jump-start" things. Another member, @tdonline, used it for about a month for that purpose. Lactulose and Miralax are stool softeners and you might want to try both (not at the same time) to see what Lily tolerates best and/or works best. Making dietary changes and improving digestion might help, too. So far, that is working well for Tim, but he was never chronically constipated, so time will tell.

 

[abbyntim]

Some websites I found helpful when dealing with Tim's second episode, when we realized this was a real problem (we didn't take it as seriously as we should have the first time):

http://www.littlebigcat.com/health/constipated-cats/

http://www.felineconstipation.org/

 

[raintyger]

Many megacolon kitties survive for years on cisapride. I would get the situation stabilized hopefully by using cisapride. Join the Yahoo! group that others have given a link to, it is very good. After you get the situation stabilized you will have some decisions to make as far as diet (wet food is key) and if you want to try any alternatives to cisapride. Cisapride is the most effective treatment short of surgery, but it does have drawbacks. Other treatments will require a lot of trial and error. If you go this route get a good doctor, one that will work with you. Most likely a holistic or integrated vet, as most traditional vets will not be interested in all the experimentation.

If the stool was soft, then the lactulose is doing its job. Lactulose and Miralax both do the same thing, make the stool soft, by drawing water into the colon. Many owners feel that Miralax does a better job of this, but switching to Miralax will not cause better gut motility, that is what the cisapride is for. I would still consider switching, though, because most owners prefer Miralax. Not only do they feel Miralax is more effective, but also it is much less expensive, not a sticky mess, and OTC.

Good luck and let us know how he does.

 

[micknsnicks2mom]

@fatlily29 -- how is your lily doing?

 

[ChrisC607]

I know this is an older thread but I cannot figure out how to post anything new. I need help of some sort. I will be going into the Vet but they can't see her until 11 am. It's currently 9 a.m. she's been awake for over 48 hours since 4 a.m. Saturday at least. That's when I gave her the medicine the lactulose. By noon she was looking uncomfortable. At 2 p.m. she was in pain. And by 4 p.m. she was in complete and total agony. She's shown no signs of Improvement. If anything she's got worse. She has not slept in over 48 hours because she is in complete agony. You can hear the gas gurgling and bubbling inside of her she has a tumor pressing against her bile ducts and she's been receiving prednisolone. She responded quite well to it and started eating regularly finally. Which created the constipation issue. Miralax had no effect on her. She went in Friday and got prescribed the lactulose and I gave it to her Saturday morning. I have not gave her any since because she's been in so much pain from the one dose. Have not gave her any Miralax. The reason I waited until Saturday morning was to make sure the Miralax had cleared her system cuz I didn't want her to experience any cramping or pain. Lack of bile salts causes fats and oils to not be able to be digested properly and cause blockage. I warned the vets that laxatives would not help her and would probably put her in pain by adding to the pressure without addressing the cause. I was right. But I don't know what to do now. She is in complete and total agony. I will bring her in as soon as I can but if there's anything that could help even a moment sooner she needs it. I know she hasn't slept because neither have I. I've been at her side the whole time she keeps going to the litter box trying to go but is unable to get anything out

 

[Forrest&Kiara]

Hi Everyone- I'm new on here but I desperately need advice regarding my cat who has been on lactulose for the last week or so. He went into the vet a week ago because he was extremely constipated (vomiting, wouldn't eat, couldn't poop, etc). They cleaned him out & he was like a different cat...eating, happy, etc. They had me give him 3ml of lactulose, three times a day (for reference, he's 22 lbs). After about 6 days on that, he started having horrible diarrhea that was leaking out of him (sorry, gross) and hasn't eaten in a few days and this morning, he threw up foamy bile. It's very obvious that he's not feeling well because of the high amount of lactulose he's on so I stopped the medicine two days ago (against the advice of my vet...they recommended reducing the dosage to 2ml twice a day when I called yesterday) and he is still having diarrhea and just overall, doesnt feel great and won't eat.

I put a call into my vet this morning when they opened & some vet tech called me back after they closed, who didn't seem to know anything and she basically told me to go to an emergency vet clinic because they were closed and couldn't do anything. Does anyone have any ideas for what to do without taking him to an emergency clinic and paying hundreds of dollars? I asked my vet for an anti-nausea drug and they wouldn't give me one until Monday because they closed today and I just can't have him sitting here with diarrhea, throwing up, etc until my vet can get around to giving him an anti-nausea drug (quite irritated with my vet right now). I know cats can't have pepto-bismol..but is there anything else that will help him?

Hello, I see this is an older post but still have something to offer. I have a mobile vet who leaves me with everything I may need for my diabetic kitty, since she must eat with her insulin. Being mobile, she is not always available, so she hooks me up. She has prescribed Lactulose, and I don't care for the side effects. Just today (5-13-21) I saw my little diabetic drooling and tested her - drop way too fast. I had in injection of cerenia ready to go, and while it really stings (gotta do it fast), she was eating within a minute. I shot just over the spine since she had had fluids previously, and while I have injected into the port with fluids, there's nothing more fast acting that a direct sub-q injection of cerenia. Any vet who refuses to give you medications needed when they aren't available should be replaced with a vet who will. To tell you to take your baby to the ER is out of line. I'd dump that vet in a heartbeat!
So I make up a nice natural mix of slippery elm with Optigest (digestive enzymes) that helps with both diarrhea and constipation. It soothes everything. I've made the decoction before too, a stronger "tea" with little to no taste. Cats seem to prefer that. It requires cut and sifted (organic) slippery elm and cut and sifted marshmallow root. I found it on Etsy for a great price. Keep in mind that Dutch Elm Disease is a crucial factor in choosing your products, so I asked the Etsy sellers before I bought.
For diarrhea, I have two natural choices depending on severity. If it's mild, I pack a #1 gel cap with Terramin Clay - it's a real feel good, gives lots of nutrients and removes toxins. If diarrhea is bad, I use Saccharomyces Boulardii plus MOS (probiotic + prebiotic), a single remedy that stops diarrhea in its tracks. Jarrow is a clean brand - no fillers. I hope this helps. Natural is always better in my book. My vet has recommended fiber and I say phooey. This works for all my cats.

 

[Forrest&Kiara]

Oh he's definitely not constipated. That was the original issue...however, they anesthetized him last week, cleaned him out, and kept him over night & ensured he was unconstipated by doing an X-ray. Thats why he was started on such a high dosage of lactulose- so that he wouldn't become constipated again.

 

[Forrest&Kiara]

I had a kitty with mega-colon and nothing they did worked! He was too chubby to work out the blockage, so the hospital cut them open and accidentally cut his intestine. That was not a long term solution. Nothing worked, not Lactulose, not stool softeners, nothing. Years later the issue reared it's head again, and I called the vet and she came to the house for an enema, but she didn't get it all. She did, however, drop her tubing, and with this particular cooperative cat, I gave him enemas until I discovered what did work. He got a #4 gel cap packed with Nature's Way Aloe latex with fennel and he got one of those every 18 hours for the rest of his beautiful 19 years.